PASG stands for Pneumatic Anti-Shock Garment and is sometimes referred to as MAST (Medical Anti-Shock Trouser).
This is designed to provide uniform pressure on the lower extremities and abdomen. This is used in some EMS systems on shock and hemorrhage patients.
The PASG device is intended to compress the vascular space and accomplish 4 objectives:
1) Increase peripheral vascular resistance by pressurizing the arteries of the lower abdomen and extremities.
2) Reduce the vascular volume by compressing venous vessels.
3) Increase the central circulating blood volume with blood returned from areas under the garment.
4) Immobilize the lower extremities and the pelvic region.
The proper use and application of the PASG can return about 250 mL of blood back to the central circulation.
There are some concerns with the use of the PASG, among them are
* The abdominal part of the PASG pressurizes the abdominal cavity and increases the work associated with breathing.
* This can reduce chest excursion.
* Studies have shown that application of PASG in cases of penetrating chest trauma has increased mortality.
* PASG may be detrimental to patients with uncontrolled internal hemorrhage.
Indications for using the PASG include:
> shock patients w/ controlled hemorrhage
> patients w/ pelvic fracture and instability w/ hypotension
> patients w/ possible neurogenic shock
> any shock patients w/ uncontrolled hemorrhage below the mid-abdomen.
< Poulmonary edema
< Cardiogenic shock
Make sure that vitals are taken before application of the PASG and then again after it is applied and inflated. Then continue to monitor vitals frequently. The purpose of using the PASG is not to return the blood pressure and circulation to normal levels, but instead to stabilize the patient's condition. Once inflated, the PASG shoudl not be deflated in the prehospital setting. Releasing the pressure reduces the peripheral vascular resistance and expands the size of the vascular space and removes about 250 mL of blood from the active circulation. This could seriously harm the patient as they are trying to compensate for shoc